| NPI | 1942784228 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: TX MT124590) |
| Enumeration Date | 2018-09-21 |
| Last Update Date | 2019-07-15 |